Quantitative Changes in Gait Parameters after Cycling among Multiple Sclerosis Patients withAtaxia:APilot Study

Introduction: Cerebellar ataxia is a common symptom of multiple sclerosis (MS), particularly in progressive forms, where gait and balance problems are the most debilitating symptoms.  Exercise  training  is  a  critical  component  of  rehabilitation  in managing equilibrium dysfunction, and stationary  bicycling  is  a  safe,  feasible,  and effective method to reduce the symptom. Clinical walking performance tests are typically used to assess gait in these patients. However, gait analysis technologies are more sensitive and accurate at detecting subtle and subclinical changes. The purpose of this study was to determine the changes in gait parameters in MS patients with ataxic gait after using a stationary bicycle. Materials and Methods: Ten  secondary progressive MS patients with ataxic gait and  a mean expanded disability status scale (EDSS) of four were recruited. The participants cycled on a stationary bike. Gait analysis was performed before and after 12 sessions of cycling. It included spatiotemporal and balance parameter measurements. Results: Gait analysis showed statistically significant changes in spatiotemporal parameters, including speed (P=0.02, r=-0.51), and stride length (P=0.01, r=-0.63). Of balance-related indices, the mediolateral (ML) center of pressure (COP) displacement, anterior and posterior COP overshoot, and COP velocity changes were statistically remarkable after the intervention respectively. (P=0.01, r=-0.63), (P=0.02, r=-0.51), (P=0.03, r=-0.49), (P=0.01, r=-0.54). Conclusion: Gait analysis is applicable to track changes following rehabilitation in individuals with MS. The results indicate that using a stationary bicycle can improve some spatiotemporal and COP-related parameters.